| Objective:To investigate the correlation and predictive value of serum cyrsteine-rich protein 61(Cyr61),receptor-interacting protein kinase3(RIPK3),monocyte/high-density lipoprotein cholesterol ratio(MHR)with the diagnosis of coronary artery disease(CAD)and the degree of coronary artery disease,in order to find new indicators for early diagnosis and risk assessment of CAD.Methods:This study included 198 patients who were hospitalized and underwent coronary angiography(CAG)in the Department of Cardiology of the Affiliated Hospital of Chengde Medical College from November 2021 to June 2022,according to the results of CAG and diagnostic criteria,they were divided into a total of 137 patients in the CAD group(CAG showed that at least one main coronary artery or its main branch stenosis≥50%)as the observation group,a total of 61 patients in the non-CAD group(CAG showed that the stenosis of the main coronary artery or its main branches was less than 50%or no stenosis)served as the control group.The Gensini score was calculated according to the degree of coronary artery stenosis,the CAD group was divided into low score group and high score group according to the median method.Compare the differences between clinical and laboratory test results in the diagnosis group,the area under the ROC curve was used to evaluate the diagnostic value of Cyr61,RIPK3,MHR and their combination in patients with CAD,multivariate logistic regression analysis was used to study the related influencing factors of CAD,and the differences between the groups of Cyr61,RIPK3,MHR levels in the Gensini score group were compared,analyze the correlation between the levels of Cyr61,RIPK3,MHR and Gensini score in CAD group.Results:1.Comparison of general data between observation group and control groupThere was no statistically significant difference between the two groups in age,proportion of CAD family history,fasting blood glucose,systolic blood pressure,diastolic blood pressure,total cholesterol,platelets,plateletocrit,platelet distribution width,mean platelet volume,body mass index(P>0.05).Comparison between CAD group and non-CAD group,proportion of male 100(72.99%)VS 26(42.62%),proportion of hypertension 83(60.58%)VS 26(42.62%),proportion of diabetes 39(28.47%)VS 7(11.48%),proportion of smoking 75(54.74%)VS 19(31.15%),triglyceride 1.54(1.05～2.47)VS 1.12(0.93～1.81)mmol/L,low-density lipoprotein cholesterol 2.92(2.35-3.56)VS 2.22(1.87-2.84)mmol/L,white blood cell 7.45(5.73～9.11)VS 6.39(5.48～7.77)×10~9/L,neutrophil 4.93(3.56～6.93)VS 3.81(2.96～5.18)×10~9/L and monocyte 0.56(0.43～0.74)VS 0.47(0.37～0.60)×10~9/L were higher,high-density lipoprotein cholesterol 1.08±0.26 VS 1.26±0.30 mmol/L and lymphocyte1.67(1.15～2.19)VS 2.02(1.61～2.49)×10~9/L were lower,there were statistical differences(P<0.05).2.Serum levels of Cyr61,RIPK3 and MHR were compared between observation group and control groupThe levels of Cyr61,RIPK3 and MHR in CAD group were significantly higher than those in non-CAD group,which were Cyr61 114.68(103.16～155.63)VS 90.31(61.16～122.38)pg/ml(P<0.05),RIPK3 28.60(24.49～34.19)VS 19.91(16.19～29.17)ng/ml(P<0.05),MHR 0.57(0.41～0.82)VS 0.35(0.26～0.54)(P<0.05).3.Diagnostic value of Cyr61,RIPK3 and MHR levels in CADAccording to the ROC curve analysis,the area under the ROC curve of Cyr61 diagnosis of CAD was 0.758(95%CI:0.680～0.816,P<0.05),and the best diagnostic threshold was≥93.585pg/ml.The area under the ROC curve of RIPK3 diagnosis of CAD was 0.700(95%CI:0.680～0.837,P<0.05),and the best diagnostic threshold was≥22.31ng/ml.The area under the ROC curve for MHR diagnosis of CAD was 0.737(95%CI:0.657～0.816,P<0.05),and the best diagnostic threshold was≥0.4583.The diagnostic value of Cyr61,RIPK3 and MHR in combination for CAD was higher than that of the three alone,and the area under the ROC curve was 0.780(95%CI:0.706～0.854,P<0.05).4.Regression analysis of influencing factors of CADThrough single factor analysis,it was found that male,hypertension,diabetes,smoking,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,white blood cell,lymphocyte,Cyr61≥93.585pg/ml,RIPK3≥22.31ng/ml,MHR≥0.4583 were the influencing factors of CAD(P<0.05).After multivariate binary logistic regression analysis,diabetes(OR=5.120),low-density lipoprotein cholesterol(OR=2.939),Cyr61≥93.585pg/ml(OR=8.716),RIPK3≥22.31ng/ml(OR=8.336),MHR≥0.4583(OR=4.974)can be regarded as independent influencing factors of CAD(P<0.05),lymphocyte(OR=0.172)can be regarded as an independent protective factor of CAD(P<0.05).5.Comparison of serum Cyr61,RIPK3 and MHR levels between Gensini score groupsAccording to the Gensini score of patients with CAD,they were divided into high score group(>36 points,n=67)and low score group(≤36 points,n=70)by the median method,and through Mann-Whitney U rank sum test,there were statistical differences in the levels of Cyr61,RIPK3 and MHR between the high and low groups of Gensini score,the high score group is higher than the low score group,Cyr61 140.20(109.38～173.60)VS 107.55(99.28～123.28)pg/ml(P<0.05),RIPK3 33.19(28.02～39.45)VS 26.79(22.41～28.82)ng/ml(P<0.05),MHR 0.62(0.45～0.94)VS 0.52(0.40～0.70)(P<0.05).6.Correlation analysis of Cyr61,RIPK3,MHR levels and Gensini score in patients with CADAccording to Spearman correlation analysis,the levels of Cyr61,RIPK3and MHR were positively correlated with the Gensini score in patients with CAD,Cyr61 r=0.437(P<0.001),RIPK3 r=0.472(P<0.001),MHR r=0.179(P<0.05).Conclusions:1.The serum levels of Cyr61,RIPK3 and MHR in CAD patients were higher than those in non-CAD patients,which has certain value for the diagnosis of CAD,in addition,serum Cyr61≥93.585pg/ml,RIPK3≥22.31ng/ml,MHR≥0.4583 can be regarded as independent risk factors for CAD.2.There were significant differences in serum Cyr61,RIPK3 and MHR levels between the high and low Gensini score groups,and their levels are positively correlated with the Gensini score,indicating that the detection of the three levels can predict the degree of coronary artery stenosis to a certain extent,and provide reference value for the follow-up treatment plan. |
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